探讨绝经后女性冠状动脉粥样硬化性心脏病（CHD）患者的危险因素及其焦虑抑郁状态。

选取2015年1月至2016年6月行冠状动脉造影术的绝经后女性CHD患者228例。根据冠状动脉造影术中Gensini评分是否≥ 41分分为支架组（150例）及造影组（78例）。比较两组患者的雌二醇、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、卵泡刺激素（FSH)及同型半胱氨酸（HCY）水平，并进行Logistic回归分析。同时采用Ridit分析对两组患者医院焦虑抑郁量表（HADS）评分进行比较，采用Spearson相关分析探讨支架组患者Gensini评分与HADS评分的相关性。

与造影组比较，支架组患者的雌二醇[（14.9 ± 1.1）ng/L vs.（10.9 ± 0.4）ng/L，t=3.324，P=0.001]及HDL-C[（1.236 ± 0.043）mmol/L vs.（1.132±0.023）mmol/L，t=2.343，P=0.020]水平明显降低，总胆固醇[（5.16 ± 0.04）mmol/L vs.（6.18±0.08）mmol/L，t=11.845，P<0.001]、LDL-C[（2.90 ± 0.06）mmol/L vs.（3.72 ± 0.06）mmol/L，t=8.713，P<0.001]及HCY[（10.64 ± 0.26）μmol/L vs.（17.81 ± 0.60）μmol/L，t=11.057，P<0.001]水平明显升高，而两组患者FSH水平比较，差异无统计学意义[（20.9 ± 1.3）IU/L vs.（20.8 ± 0.7）IU/L，t=0.055，P=0.082]。Logistic回归分析显示，雌二醇、总胆固醇、HDL-C、LDL-C及HCY水平是绝经后女性CHD患者的独立危险因素（P均<0.05）。同时，造影组患者HADS评分明显优于支架组（u=1.110，P<0.05）。且支架组患者Gensini评分与HADS评分呈正相关性（r=0.604，P< 0.05）。

雌二醇、总胆固醇、HDL-C、LDL-C及HCY水平是绝经后女性CHD患者的独立危险因素，且患者的焦虑抑郁状态与冠状动脉病变呈正相关。

To investigate the risk factors and anxiety-depression state in postmenopausal women with coronary atherosclerotic heart disease (CHD).

A total of 228 postmenopausal women with CHD undergoing coronary angiography from January 2015 to June 2016 were enrolled in this study. All patients were divided into the stent group (Gensini scores ≥ 41, n=150) and angiography group (Gensini scores<41, n=78). The levels of estradiol, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), follicle-stimulating hormone (FSH) and homocysteine (HCY) were detected and compared. Logistic regression models were used to assess the potential risk factors of postmenopausal women with CHD. The hospital anxiety and depression scale (HADS) was compared by Ridit analysis. The relationship between Gensini scores and HADS scores was analyzed by Spearson correlation analysis.

Compared with the angiography group, the levels of estradiol [(14.9 ± 1.1) ng/L vs. (10.9 ± 0.4) ng/L, t=3.324, P=0.001] and HDL-C [(1.236 ± 0.043) mmol/L vs. (1.132 ± 0.023) mmol/L, t=2.343, P=0.020] were much lower; the levels of total cholesterol [(5.16 ± 0.04) mmol/L vs. (6.18 ± 0.08) mmol/L, t=11.845, P<0.001], LDL-C [(2.90 ± 0.06) mmol/L vs. (3.72 ± 0.06) mmol/L, t=8.713, P<0.001] and HCY [(10.64 ± 0.26) μmol/L vs. (17.81 ± 0.60) μmol/L, t=11.057, P<0.001] were much higher in the stent group. However, there were no significant differences in FSH levels between the two groups [(20.9 ± 1.3) IU/L vs. (20.8 ± 0.7) IU/L, t=0.055, P=0.082]. The Logistic regression analysis showed that estradiol, total cholesterol, HDL-C, LDL-C and HCY were independent risk factors for postmenopausal women with CHD (all P< 0.05). The HADS scores in the angiography group were much better than those in the stent group (u=1.110, P < 0.05). The Spearson correlation analysis showed a positive correlation between the Gensini score and HADS score in the stent group (r=0.604, P < 0.05).

The risk factors of postmenopausal women with CHD include estrogen, total cholesterol, HDL-C, LDL-C and HCY, and the severity of coronary artery disease is positively correlated to patient's anxiety-depresssion state.